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Warning Signs of Fentanyl Use: Preventing Addiction and Overdose

Medically reviewed by Dr. Po-Chang HsuNovember 11, 2024
Written by
On November 11, 2024

Table of Contents

Key Points

  • Fentanyl is a powerful synthetic opioid that’s used for pain management.
  • With its high potency, fentanyl has a high potential for abuse and addiction.
  • There are serious risks to fentanyl abuse, including addiction and overdose.
  • Learning the signs of fentanyl use and abuse can help prevent adverse effects.

Fentanyl is a powerful synthetic opioid often prescribed for severe pain management, but it’s also an extremely dangerous opioid that’s found on the illicit market. Its misuse poses severe risks, including addiction and overdose.

Recognizing the signs of fentanyl use and understanding prevention strategies is crucial for early intervention and saving lives.

What Is Fentanyl?

Fentanyl is a powerful synthetic opioid that’s similar to morphine but 50 to 100 times more potent.[1] It has legitimate medical uses to manage severe pain that hasn’t responded to other pain management, but it’s also found on the illicit market – both knowingly and unknowingly.

Fentanyl is classified as a Schedule II controlled substance under the Controlled Substances Act due to its medical uses and high potential for abuse. It’s available under prescription names such as Sublimaze and Duragesic, while street names include Apache, Goodfella, Murder 8, and Dance Fever.[2]

According to the Centers for Disease Control and Prevention (CDC), a significant proportion of the estimated 81,083 opioid overdose deaths in 2023 were attributed to fentanyl.[3]

Side Effects of Fentanyl

Fentanyl can cause a variety of side effects, including:[4]

  • Nausea
  • Vomiting
  • Drowsiness
  • Constipation
  • Slowed breathing (respiratory depression)
  • Confusion
  • Dizziness
  • Low blood pressure (hypotension)
  • Slow heart rate (bradycardia)
  • Headache
  • Sweating

 

Fentanyl is a highly addictive opioid that can cause physical dependence, addiction, withdrawal, and overdose.

How Is Fentanyl Used?

Fentanyl is used in different ways to produce different effects. As a prescription medication, fentanyl is often used as a transdermal patch to release the pain-relieving effects slowly. It may be prescribed as a tablet, intranasal spray, or intramuscular injection to relieve breakthrough pain rapidly.

When used illicitly or misused, fentanyl may be ingested in pill form. People also crush and snort or inject lozenges for a potent high or smoke the concentrated medication from the transdermal patch.

Effects of Fentanyl Abuse

In the short term, fentanyl abuse may cause:[5]

  • Drowsiness
  • Euphoria
  • Confusion
  • Small pupils
  • Nausea
  • Vomiting
  • Constipation
  • Slowed breathing

 

Long-term fentanyl abuse may cause:[6]

  • Chronic, severe constipation
  • Breathing troubles while sleeping
  • Immune system suppression
  • Hormonal problems
  • Reproductive problems
  • Heart attack or other heart problems
  • Mood disorders
  • Depression
  • Anxiety
  • Dependence
  • Addiction
  • Overdose

Fentanyl Overdose

Illicitly produced fentanyl is one of the primary causes of fatal overdoses in the US. Mixing fentanyl with other drugs, which may occur without intention, significantly increases the risks. However, overdose is possible with prescription fentanyl because of the drug’s potency.

The signs of fentanyl overdose include:[7]

  • Loss of consciousness
  • Shallow or stopped breathing
  • Pinpoint pupils
  • Body limpness
  • Cold and clammy skin
  • Choking or gurgling

 

If you suspect someone is overdosing on fentanyl, call 911 immediately. Wait with the person until help arrives. Try to keep them conscious and turn them on their side to prevent choking if they vomit. You can administer naloxone if you have it, which can help to reverse the overdose and buy time for help to arrive.

Risks of Fentanyl

Using fentanyl in the long term, especially recreationally, can have serious physical and mental consequences. Tolerance builds with fentanyl quickly, which means you need higher or more frequent doses to get the same effect. Long-term use of fentanyl also leads to physical dependence, which is when the body becomes used to the presence of the drug. If you stop taking it suddenly, withdrawal can occur.

Physical dependence isn’t addiction on its own, but it can be part of it. Addiction is the compulsive use of fentanyl despite the problems it causes and the possible risks. Fentanyl abuse and addiction significantly increase the risk of overdose.

In addition to the direct risks, fentanyl can have long-term health effects like low blood pressure, poor heart health, and problems with memory and attention. Abusing fentanyl in certain ways, such as intravenously, can increase the risk of contracting infectious diseases like hepatitis and HIV.

If you combine fentanyl with other drugs, or take illicit drugs that have fentanyl added, it can lead to unpredictable and dangerous effects. Mixing fentanyl with other central nervous system (CNS) depressants like alcohol or benzodiazepines can depress the respiratory system to dangerous levels and sedate the body to the point of unconsciousness or death.[8] Conversely, mixing fentanyl with stimulants, which have the opposite effect, can strain the cardiovascular system, or both drugs can amplify the effects of one another.

Fentanyl Withdrawal

Fentanyl withdrawal occurs when you’re physically dependent on the drug and stop using it abruptly. Some of the withdrawal symptoms may include:[9]

  • Flu-like symptoms
  • Diarrhea
  • Nausea
  • Vomiting
  • Joint pain
  • Muscle pain
  • Abdominal cramps
  • Sweating
  • Chills
  • Sleep problems
  • Restlessness
  • Mood swings
  • Depression
  • Anxiety
  • Increased pain perception
  • Intense cravings

Fentanyl withdrawal can be intense and extremely uncomfortable, putting you at risk of relapse.

Signs of Fentanyl Abuse and Addiction

A fentanyl addiction is an opioid use disorder (OUD). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for OUD include:[10]

  • Taking opioids for longer periods or in higher amounts than intended
  • Spending an excessive amount of time obtaining, using, or recovering from opioids
  • Experiencing cravings for opioids
  • Unsuccessful attempts to stop or reduce opioid use
  • Continuing opioid use despite interpersonal problems
  • Problems at work, school, or home because of opioid use
  • Engaging in reckless or dangerous behaviors while using opioids
  • Giving up activities once enjoyed because of opioid use

 

There may be other signs of fentanyl use, such as visiting multiple doctors for prescriptions, secretive behaviors, financial troubles with no obvious cause, lying, neglecting personal hygiene or appearance, weight changes, and mood changes.

Treating Fentanyl Addiction

Fentanyl withdrawal can be intense, especially with high doses or long-term use. Opioid withdrawal is generally not life-threatening but can lead to complications such as electrolyte imbalances from prolonged vomiting and diarrhea.

Treating fentanyl addiction often starts with medical detox. This provides a medical team to monitor your health, administer medications to help with withdrawal symptoms and prevent complications.

After detox, it’s important to enter an addiction treatment program to address the emotional, social, and psychological aspects of fentanyl addiction. Treatment plans are individualized according to your unique needs and goals. However, inpatient and outpatient programs often use individual and group counseling, support groups, and behavioral therapies like cognitive behavioral therapy and motivational interviewing.

Get Help for Fentanyl Addiction

Fentanyl is an extremely potent opioid that’s used in medical settings and illicitly. Fentanyl is highly addictive and comes with serious risks, including addiction and fatal overdose. If you or a loved one is abusing or addicted to fentanyl, it’s important to seek help as soon as possible to avoid adverse effects.

Medical Content Writer

Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.

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Frequently Asked Questions About Fentanyl Use

Fentanyl is 50 to 100 times more potent than morphine. Small doses can be enough to cause a fatal overdose, especially when it’s combined with other drugs – intentionally or otherwise.

Fentanyl can affect people differently, but you may notice signs like pinpoint pupils, mood changes, secretive behaviors, and stealing or lying.

If you’re prescribed fentanyl, make sure you use it only as directed by your doctor or pharmacist. Never share your prescription or take someone else’s medication. Store medications securely and out of reach of others, and educate yourself about the risks of fentanyl misuse.

Fentanyl has been added to illicit drugs without the knowledge of the person using them, which has led to fatal overdoses. There’s no way to detect fentanyl in another drug by sight, smell, or taste, but there are tests available to look for fentanyl. However, while tests are available to detect fentanyl in drugs, abstaining from drug use entirely is the only guaranteed way to avoid exposure.

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[1] U.S. Department of Health and Human Services. (2024, September 24). Fentanyl. National Institutes of Health. Retrieved from https://nida.nih.gov/research-topics/fentanyl 

[2] Fentanyl: Uses, interactions, mechanism of action | DrugBank Online. (n.d.). Retrieved from DrugBank. https://go.drugbank.com/drugs/DB00813 

[3] Centers for Disease Control and Prevention. (2024, May 15). U.S. overdose deaths decrease in 2023, first time since 2018. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm 

[4,5,6,7,8,9] U.S. National Library of Medicine. (n.d.-a). Fentanyl: Medlineplus drug information. MedlinePlus. Retrieved from https://medlineplus.gov/druginfo/meds/a605043.html 

[8] Drinking alcohol while using other drugs can be deadly. (2024, May 15). Alcohol Use. Retrieved from https://www.cdc.gov/alcohol/about-alcohol-use/other-drug-use.html 

[10] Opioid use disorder (OUD). PsychDB. (2021b, May 3). Retrieved from https://www.psychdb.com/addictions/opioid/1-use-disorder 

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